CQC report explained · a residential care home
What the CQC found at Alexandra Lodge Care Home
Rated Inadequate: inspectors found the home performing badly and the CQC has taken enforcement action.
What inspectors found, November 2023
Inspected but not rated; inspectors found many safety improvements, but five previous breaches remained because no people were living there.
This was a targeted inspection on 3 October 2023. Inspectors looked only at concerns from the previous inspection, rather than reviewing the whole service. There were no residents because the registration had been suspended.
Inspectors found improvements to fire safety, window restrictors, radiator covers, water temperatures, legionella controls, food safety, medicines guidance, cleanliness, staffing planning and policies. The main boiler was not working, although action had been taken to fix it and no new admissions were planned until it was repaired.
The service was inspected but not rated. The previous ratings of inadequate for Safe and Well-led were not changed because this inspection did not cover every part of those areas. Five previous breaches remained because inspectors could not fully assess them without people using the service.
Improved environmental safety
Fire doors, window restrictors and radiator covers had been improved. Water temperatures were controlled to reduce scalding risks.
“At this inspection, we saw the environment had been improved to reduce the risk of fire.” from the report
Cleaner premises
The home was clean and did not have the malodours found at the previous inspection. New cleaning checks had also been introduced.
“At this inspection, we found the home to be clean with no malodours.” from the report
Better food safety guidance
Staff, including kitchen staff, had completed choking-management training. Guidance was available on preparing food with the right texture.
“All staff including kitchen staff had completed training in the management of choking.” from the report
More structured staffing planning
The provider had introduced a tool to calculate staffing levels according to people's needs. This had not yet been tested with residents.
“The provider had sought specialist support and invested in a staffing dependency tool to calculate the number of staff required based on people's needs.” from the report
Five previous breaches remained
seriousBreaches relating to safeguarding, safe care, staffing, recruitment and governance remained because inspectors could not fully assess them without residents using the service.
“This means that these breaches of regulation remain and will be reassessed if suitable at a future inspection of the service.” from the report
Boiler not working
needs fixingThe main boiler was not working during the inspection. The provider said it would not admit new people until it was fixed.
“We found the main boiler was not working however action had been taken to ensure this was fixed, the provider did not plan on admitting new people to the service until the boiler was fixed.” from the report
DoLS oversight was not yet in place
needs fixingThe provider had not created a governance tool to oversee new deprivation of liberty referrals. Inspectors could not assess whether this system would work.
“As no tool had been created, we were unable to assess the effectiveness of this.” from the report
- 01Has the main boiler now been repaired, and what evidence can you show that it is safe before admitting anyone?
- 02What staffing levels would be provided for my relative's needs, and how will the dependency tool be used and checked?
- 03How will you monitor the five previous breaches once people move in, especially safeguarding, recruitment and governance?
- 04What system is now in place to review any deprivation of liberty referrals and make sure restrictions remain necessary and lawful?
- 05What are the current legal conditions on the service, and how will you show that they are being followed?
This was a targeted inspection of specific concerns from the previous inspection, mainly Safe and Well-led; it did not review the whole service or change the previous ratings. This explanation was written from the published report of 17 November 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, August 2023
Inspected but not rated; previously rated Inadequate and still in special measures, with serious safety concerns and a suspended registration.
This was a targeted inspection on 2 August 2023. Inspectors looked at whether the home had improved after the previous inspection and suspension. There were no residents, so inspectors walked around the building, checked records, and spoke to two care staff and the responsible person.
Some changes had been made. Staff had received medicine training, furniture had been secured, cleanliness had improved in some areas, and updated DBS checks had been applied for. However, important risks remained. These included unsafe hot water, fire doors that did not close, windows without adequate restrictions, choking risks, water maintenance problems, unclear medicine processes, and concerns about staffing.
The home was not rated again because this inspection did not cover the full Safe or Well-led questions. The previous overall rating was Inadequate, and the home remains in special measures. Its registration was suspended, so it could not support residents at the time of inspection.
Medicine training
Staff had received training in giving medicines safely. However, the home still lacked clear written processes for managing and monitoring medicines.
“At this inspection, staff had now received medicine training.” from the report
Furniture secured
Furniture that had previously been a risk had been secured to the walls.
“At this inspection, we saw freestanding furniture had been safely secured to the walls.” from the report
Some cleanliness improvements
The home was cleaner than at the previous inspection, and inspectors did not find concerns with mattresses. Cleaning was not yet fully consistent.
“We did not identify any mattress concerns at this inspection.” from the report
Updated DBS checks
The provider had applied for updated DBS checks for all staff. The recruitment policy still did not explain how often future checks should happen.
“At this inspection, the provider had applied for updated DBS checks for all staff.” from the report
Fire safety
seriousThree fire doors still did not close correctly, increasing the risk that fire could spread through the building.
“3 fire doors still did not close correctly.” from the report
Scalding and falls
seriousInspectors found water temperatures that could scald people and two windows where the risk of falling remained.
“We found one sink at 69°C and one shower at 48°C.” from the report
Choking risk
seriousKitchen staff did not have the knowledge and guidance needed to prepare food with suitable textures for people with swallowing needs.
“At this inspection, kitchen staff still did not have the knowledge and guidance on how to prepare suitably textured food.” from the report
Water-system maintenance
seriousRequired maintenance had not been completed, increasing the risk of harmful bacteria building up in the water system.
“These maintenance routines had not been completed which increases the risk of this bacteria build up.” from the report
Staffing levels
seriousThe provider said staffing levels would not increase if residents returned. Inspectors also found the staffing tool did not produce clear staffing levels.
“The provider advised that staffing levels would not change if they supported people again.” from the report
Medicine processes
needs fixingAlthough staff had received medicine training, the written guidance was poor and did not explain clearly how medicines would be managed safely.
“There was a lack of guidance on how medicines would be managed safely.” from the report
- 01Have the three fire doors now been repaired and tested so they close correctly?
- 02Have the sink and shower water temperatures been reduced and checks introduced to prevent scalding?
- 03What training and written guidance will kitchen staff have before anyone with swallowing needs moves in?
- 04What staffing numbers will be provided for different numbers and needs of residents, and how will this be calculated?
- 05What clear medicines policy and monitoring system will be in place before the home supports residents again?
This was a targeted inspection of specific concerns from the previous inspection, not a full assessment of all five key questions, so the previous ratings remained and no residents were observed. This explanation was written from the published report of 26 August 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Alexandra Lodge Care Home
3 rated inspections over 5 years: the service has slipped, from Good to Inadequate.
- November 2023Inspected but not ratedcurrent ratingSafe: Inspected but not ratedWell-led: Inspected but not rated
- August 2023Inspected but not ratedSafe: Inspected but not ratedWell-led: Inspected but not rated
- July 2023Inadequatestayed InadequateSafe: InadequateEffective: InadequateCaring: GoodResponsive: GoodWell-led: Inadequate
- June 2023Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- June 2018GoodSafe: GoodEffective: GoodWell-led: Good
- February 2017
Registered with the Care Quality Commission on 7 February 2017.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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